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General NPI Number Information
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NPI Number | 1770601007
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Entity Type | Individual
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Provider Name | JEREMII WITOLD WESOLOWSKI PH.D., R,PH.
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Gender | Male
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3851 ROSECRANS ST
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City | SAN DIEGO
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State | CA
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Zip | 92110-3115
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Country | US
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Telephone | 619-692-5600
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Fax | 619-692-6696
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Provider Business Mailing Address
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Address Line | PO BOX 187
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City | YORBA LINDA
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State | CA
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Zip | 92885-0187
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Country | US
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Telephone | 619-692-5600
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Fax | 619-692-6696
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 56335
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License Number State | CA
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